Overall, VEMP response parameters were found to have fair to good test-retest reliability. The intraclass correlation coefficient value for amplitude was found to be more reliable than latency, with the latency of n23 more reliable than the latency of p13. Clinicians should consider these findings when interpreting VEMP responses. Maintenance of symmetric head rotation with and without EMG monitoring produced reliably reproducible results, the VEMP amplitude being the best criteria.

Vestibular-evoked myogenic potential (VEMP) testing is a vestibular function test used for evaluating saccular and inferior vestibular nerve function. Parameters of VEMP testing include VEMP threshold, latencies of p1 and n1, and p1-n1 interamplitude. Less commonly used parameters were p1-n1 interlatency, interaural difference of p1 and n1 latency, and interaural amplitude difference (IAD) ratio. This paper recommends using air-conducted 500 Hz tone burst auditory stimulation presented monoaurally via an inserted ear phone while the subject is turning his head to the contralateral side in the sitting position and recording the responses from the ipsilateral sternocleidomastoid muscle. Normative values of VEMP responses in 50 normal audiovestibular volunteers were presented. VEMP testing protocols and normative values in other literature were reviewed and compared. The study is beneficial to clinicians as a reference guide to set up VEMP testing and interpretation of the VEMP responses.

The purpose of this study is to review etiologies and identify the time-course of vertigo presenting in an ear, nose, and throat clinic, and serve as a reference guide for other clinics. The study includes retrospective chart review in a tertiary care, university hospital. The patient data with reported ICD-10 codes as causes of vertigo between April 2005 and December 2007 were extracted from the database. At each visit, the main diagnosis as to etiology, characteristics of the vertigo, its time-course, and patient demographic data were recorded. Of 547 cases, 17 diagnoses were made in 73.9%. Diagnostic categories included peripheral vertigo 72.9%, central vertigo 0.8%, psychogenic cause 0.2%, and unknown 26.1%. Common causes of vertigo were benign paroxysmal positional vertigo (BPPV) 52.5%, Meniere's disease 14.6%, and sudden idiopathic hearing loss 2.9%. Less common diagnoses were benign paroxysmal vertigo of childhood 0.7%, labyrinthitis 0.7%, and vestibular schwannoma 0.3%. Rare conditions were delayed endolymphatic hydrops, Ramsey Hunt syndrome, otosyphilis, vestibular neuritis, temporal bone fracture, post-concussion syndrome, cerebellar infarction, epilepsy, cervical vertigo, Streptococcus suis meningitis, and psychogenic vertigo. Ninety-nine cases who reported remission of vertigo during the study period had median onset of the remission at 4 weeks. In the ear, nose, and throat clinic at Chiang Mai University, a tertiary university hospital, peripheral vestibular disorders were the main etiology of vertigo. The three most common causes were BPPV, Meniere's disease, and sudden idiopathic hearing loss. Half of the cases who returned for follow up had remitted symptoms within 4 weeks.

Objective: To translate and evaluate psychometric properties of Thai version of the Dizziness Handicap Inventory (DHI-TH). Study Design: A cross-sectional study. Setting: Ambulatory. Patients: Fifty patients with dizziness at a vestibular clinic. Main Outcome Measures: Translation and cross-cultural adaptation of the original English version of the DHI was performed according to published guidelines. Psychometric evaluation included internal consistency, content validity, test-retest reliability, convergent validity, discriminant ability, and responsiveness. Responsiveness was examined in 28 patients with vestibular dysfunction who received vestibular rehabilitation for 6 to 8 weeks. Results: There were no floor and ceiling effects. The Cronbach's alpha was good for the total score (0.87) and subscale scores (0.70 physical, 0.73 emotional, and 0.71 functional). Excellent test-retest reliability was demonstrated for the total and subscales (ICC ranged from 0.91 to 0.97, p < 0.001). The SEM was 3.50 and the MDC was 9.68. The total and subscales of DHI-TH were moderately correlated with the SF-36-TH scores (r ranged from À0.40 to À0.63). An optimal cut-off point for detection of dizziness was 21 points (98% sensitivity, 94% specificity). Responsiveness of the DHI-TH was excellent. The ES and SRM were large (1.25 and 1.59, respectively). The DHI-TH discriminated well between patients with self-perceived improved dizziness versus unchanged dizziness (AUC ¼ 0.87). The MCID was 17 points (82.0% sensitivity, 82.0% specificity). Conclusion:The DHI-TH demonstrated good psychometric properties for patients with dizziness. The DHI-TH is a valid and reliable instrument recommended as a measure of disability and quality of life in Thai patients with dizziness.

This paper reviews the development process and discusses the key findings which resulted from our multidisciplinary research team's effort to develop an alternative digital hearing suitable for low-resource countries such as Thailand. A cost-effective, fully programmable digital hearing aid, with its specifications benchmarking against WHO's recommendations, was systematically designed, engineered, and tested. Clinically it had undergone a full clinical trial that employed the outcome measurement protocol adopted from the APHAB, the first time implemented in Thai language. Results indicated that using the hearing aid improves user's satisfaction in terms of ease of communication, background noises, and reverberation, with clear benefit after 3 and 6 months, confirming its efficacy. In terms of engineering, the hearing aid also proved to be robust, passing all the designated tests. As the technology has successfully been transferred to a local company for the production phase, we also discuss other challenges that may arise before the device can be introduced into the market.

Purpose To compare differences in happiness and stress and related factors between pre-clinical and clinical year medical students during the coronavirus disease 2019 (COVID-19) pandemic. Methods A cross-sectional study was conducted in the Faculty of Medicine, Chiang Mai University, Thailand. All undergraduate medical students were requested to voluntarily respond to an electronic survey. Demographic data, related factors of happiness and stress, scores from the Thai version of the Oxford Happiness Questionnaire (Thai-OHQ), and Thai Stress Questionnaire (Thai-ST5) were collected. Results There were 369 responses, 64.8% from preclinical students and 35.2% responses from clinical students, and 53.9% were women. The mean age of the participants was 20.62±1.81 years. The most frequent platforms that the students used to track COVID-19 information were Facebook 43.9% and Twitter 43.4%. Both groups had a low level of stress. No difference was found in the Thai-OHQ score (p=0.323) and the Thai-ST5 score (p=0.278). With multivariable analysis, two factors significantly related to the happier students included higher health satisfaction scores (p<0.001) and maintaining an exercise program during the COVID-19 pandemic (p=0.015). Conclusion There was no difference in the happiness and stress levels between the two groups during the first outbreak of COVID-19 in Thailand. To increase happiness, promoting awareness of health satisfaction and regularity of exercise for the medical students should be initiated. To direct the information during a disease outbreak such as the COVID-19 pandemic, Facebook, and Twitter are the primary platforms to use.

POSTERSmanagement, revision surgery, postopeartive flying time, facial nerve overhanging issues,and training juniors.Results: Of the questionnaires we received (182/197), 77 surgeons perform 6-15 operations/year, most (107) under GA. 123 advise stapes surgery in unilateral disease. 119 always advise patients about trying a hearing aid. 130 perform second side stapes surgery and most wait for at least 6 months for second side surgery. Stapedotomy is preferred (123), stapedectomy (11). Cause prosthesis is the most common. 57 always, and 47 never use a veingraft. 67 use laser. 64 prefer daycase surgery. 37 would abandon surgery for a 50% or more overhanging facial nerve. 34 have encountered a "gusher." 112 would recommend revision surgery. Most would advise patients "flying" after 6 weeks. Conclusion:In UK, the majority prefer GA, an overnight stay, a hearing aid trial, carrying out surgery in unilateral disease, 2nd side surgery, stapedotomy, inserting the prosthesis after removal of the stapes, advise revision surgery in conductive loss, and are willing to train trainees with an otological interest. Method: This is a retrospective case review at a tertiary care referral center. Patients included underwent a middle fossa craniotomy for repair of spontaneous CSF otorrhea between January 2007 and December 2011. The main outcome measure is the presence or absence of a dehiscent semicircular canal observed during spontaneous CSF leak repair. Otology/NeurotologyResults: Thirty-three ears in 31 patients underwent surgical repair for spontaneous CSF otorrhea via a middle fossa craniotomy. The average age at the time of repair was 60.5 years and 80.6% of patients were women. The left ear was more commonly involved in 66.7% of cases. An encephalocele was observed in 69.7% of ears. A dehiscence of the superior canal was observed in 15.2% of ears (16.1% of individuals). All ears with a dehiscent superior canal were also observed to have an encephalocele. No significant difference in age, BMI, or gender was noted between those patients with or without a superior canal dehiscence. Conclusion:The incidence of superior semicircular canal dehiscence in ears with spontaneous otorrhea is 15.2%. This incidence is greater than that reported in a temporal bone study of ears not selected for CSF otorrhea. Results: Fifty-eight cases were men and 78 cases were women. Demographic data between the 2 groups-age, gender, the side of operated ear, types of anesthesia, emergency or elective setting, BMI, history of alcohol drinking or smoking, underlying diseases, operative time, and the length of stay in the hospital-showed no significant difference. A postoperative surgical site infection was developed in 5 patients: 3 in the group with hair removal (5%) and 2 in the group without hair removal (3%) (P = .674, Fisher's exact test). All infected cases had mastoidectomy surgery. Otology/Neurotology Conclusion:Surgical site infection rate between the groups with and without hair removal showed no difference. Hair removal in ear surgery via posta...

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